Wednesday, November 30, 2011

I have been motivated by these posts and thought I'd give some simple apps a try with a client I see for counselling/ rehab. He suffered a severe TBI 10 years ago, and has support workers throughout the day, but none overnight. He relies on them for reminders and has expressed frustratiuon that he forgets things he wants to tell people. So, today we went through the Voice Recorder and the Calendar. He'd like to sync it with the computer, but the support workers use a paper diary which works well for them. So far, what I have learnt, don't try too many new things at once, and make sure the support workers are on side. I invited his support worker in to the end of the session, and went through the Voice Recorder with her. I asked her to prompt my client for times when he might use it. I suspect it will take quite a bit of work to get these 2 new reminder systems into his repertoire, but it will be worth it in my opinion, as it will give him extra independance which he desparately desires.

Very much in line with the comments of Fiona on the 3D Brain app (see a few blogs back), but this app gives 3D views as well as slize views. It is very detailed, including all the Bordmann areas with location, function and connectivity (with text information)! Maybe more suitable for our own reference now and then.

Thanks to Faye Simpson for alerting me to this website, which says it is a "market research and advisory service for the cognitive health assessment and testing market, and larger neurodiagnostic industry".

It provides online memory screening tests (digit span, spatial memory, and 'cognitive function and performance' tests), as well as downloads for 2 free cognitive screens and information on Medicare cognitive screening for the US.

The site seems to be set up to help GPs screen for cognitive difficulties in the clinic, but I worry about having a test like digit span available for people to practice on the web. Though it was amusing to read that most people can recall 8 to 10 digits in a row. Whatever happened to 7 plus or minus 2?

Making cognitive screens more available is commendable, as is raising awareness of dementia in primary health providers, but I'm not entirely comfortable about having so much information about the tests so freely available. Commercial interests seem to override the need to protect the integrity of the tests, which could render them useless...

This is one of my favorite neuropsych apps. It allows you to view a 3D model of the brain, spin it around or over and over, and view structures like the lateral ventricles that are much easier to remember if you've seen them in 3D. Which, of course, you wouldn't be able to do in dissection because they're csf-filled spaces, unless you could take a cast of them... But I digress.

3D brain is free in the app store, It provides labels for different structures, plus text info that gives links to research related to the brain structure in question. Studying neuroanatomy would have to be enhanced with this tool. Revising neuroanatomy is fun with it too.

Thiis app is almost as exciting for the neuropsych geek as the recent fMRI research into female orgasm (see http://www.medicalnewstoday.com/articles/237976.php for the researchers' account to the press, use google if you're interested in the participant's story, and if you're not inclined to blush).

This app isn't just a toy for the neuroanatomy nerd. It is also useful for talking about neuroanatomy to patients and their families - it helps put the location and type of their brain injury/stroke/tumour into perspective, and opens up opportunities for education in the feedback session. And that's what this blog is all about - how using apps can help us to help our patients better.

The free Medscape app for iPad is incredibly useful, especially for neuroosychologists working in medical settings. it's like having a medical encyclopedia on hand, (very useful if you don't know the difference between neurofibromatosis types I &II) but it goes much further, listing differential diagnoses and treatment options, and it's updated regularly. It also lists prescription and OTC medications, and their interactions.

The medscape app is particularly useful in multidisciplinary meetings when an unfamiliar diagnosis pops up, and it is also a good way to revise one's knowledge of more common conditions. And to spend time in waiting rooms reading something more informative than the magazines....

Our friends at PAR have published a nifty little app that is suitable for iPhone, iPod or iPad. It allows one to calculate a patient's age from the date of birth and the date of assessment. It also converts between percentiles, z scores, T scores and standard scores, has an in-build stopwatch and a few other, less useful, features.

I find the score converter very helpful and the age calculator comes in handy as well when I don't feel like calculating the client's age by hand.

It also has an option of purchasing a raw to scaled score conversion calculator for the following tests that may be of interest:- Personality Assessment Inventory- Behavior Rating Inventory of Executive Function- Behavior Rating Inventory of Executive Function - Adult version- Behavior Rating Inventory of Executive Function - Preschool version- MMSE and MMSE-2

If you would like to give it a try, head to the App Store and google PAR Assessment Toolkit.

Sunday, November 27, 2011

The app store has a 'game based upon one of the most frequently administered neuropsychological tests used to assess general brain function'. You can easily find it by searching for 'Trail Making Test'.The app allows you to practice the TMT to improve your performance and speed. Both Trails A and B are included, although there are fewer items than in our version (I think Trails A goes up to 10 and Trials B up to E). Otherwise, it looks almost identical.

I have also heard from a client that she has practiced Stroop on her DS. I think it is included in The Brain Training game (has anybody looked at it and can offer a review?).*

Should we start routinely asking younger clients whether they have played games that were like our tests?

Does anybody know any other tests that were converted into games?

cheers,Izabela

*It would be really good if we had lots co-authors for this blog - if you would like to become one, or to just contribute a post, just send me an e-mail (IzaWalters@gmail.com), and I'll organise access for you.

I move between my rooms and home, and do a bit of traveling. And I hate carrying heavy test suitcases, especially if I have to administer the WAIS and the WMS on one day.

My solution was to get one of those roll-on cabin bags that air hostesses and lawyers use. I was not sure if I'd like it, but it turned out to be fantastic. I got a Samsonite with one small compartment and two biger ones. The client file/s go into the small one, WAIS items into the first big one, WMS items into the second. I also managed to find space for the most frequently used bits of ACS, Wisconsin Card Sorting Test and a few bits and pieces. Front pocket fits pens, business cards and sachets of hot chocolate. It opens from the top, so you can put it beside your chair, unzip it half-way and have convenient access to your test materials without taking up desk space. It takes steps quite well, too.

For those whose gadgets are close to their hearts: I found my iPhone (between the sofa cushions, set to mute, so I couldn't hear it ring).

I will put a tracker app on it to make sure I find it quicker the next time, but there seems to be a lot of them. Can anybody recommend a good one? If there are no recommendations, see this place for a review of tracking apps next week.

Thursday, November 24, 2011

It's Done is a task manager that lets people manage daily activities. Apparently it has the power to send immediate "completed" notifications to caregivers (or clinicians), making behaviour tracking easy.

Sylvian Roy (Clinical Neuropsychologist, see also previous post) highly recommends this application as it is unique and can be used by anyone who is distractible or who has memory difficulties. He suggests case studies which examine whether the app leads to measurable changes in e.g. patients’ life satisfaction, daily functioning, and caregiver stress. For a review of this app, please see his blog (7-11-2011).

Would be fantastic to hear more experiences from clinicians, patients and caregivers.

Wednesday, November 23, 2011

The best GPS tracker is, of course, the iPhone (and probably other smartphones, but somebody else needs to fill us in on that - I haven't got a clue).

One of the apps for this is called Friend Tracker ($1.99), but there are others.

The Friend Tracker allows other authorised phones to see where you are on the map.

And as a person that has lost her iPhone this afternoon (I suspect it is lying in the kiddie's classroom, but I cannot be sure till tomorrow morning) -EVERYBODY SHOULD HAVE THIS ON THEIR IPHONE SO THAT THEY CAN TRACK IT WHEN IT IS LOST.

Carer's watch seems to be a great device for those with dementia, frail elderly, and clients that may wander off.

It looks like a watch and shows time, but can also send out an SMS with a street address in response to a call and receive incoming calls. It has two pre-programmed call buttons and a red panic button.It can also be set up to provide an invisible electronic fence (if wearer leaves safe zone, alert is generated) and SMS breadcrumbing (sending position information at pre-set intervals).

I would be interested to know if there are any privately practicing Neuropsychologists who train clients in how to use technologies such as smart phones and if so are eligible clients (with a mental health plan) accessing Medicare rebates for such "skill training" sessions.

Tuesday, November 22, 2011

This is a new blog for informal sharing of information about technology in Neuropsychology: both for our clients and for the running of our professional lives. Please share ideas and restrict criticism - this is meant to be a source of ideas and a way of sharing solutions to problems rather than a place to set standards and critique others.

If you would like to contribute, please let me know and I'll set you up as one of the authors.

Please share:- technological aids and solutions for clients and carers- the ways you use technology in your practice- interesting websites and web-based tools- information about similar blogs

If you have any questions, email me on IzaWalters@gmail.comcheers,Izabela